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Imipramine, sold under the brand names Tofranil and Tofranil PM, is the generic name of a prescription drug used to treat depression.
It may also be prescribed off-label as a non-narcotic medicine to relieve chronic pain.
Imipramine belongs to a group of drugs known as tricyclic antidepressants, or TCAs.
While TCAs have been on the market for decades, scientists are still unclear as to exactly how these drugs work.
However, they do know that they interfere with the body’s ability to draw norepinephrine and serotonin back up into nerve endings called synapses.
This increases the concentrations of these chemicals in the brain.
Originally manufactured by Sanofi Aventis, the Food and Drug Administration (FDA) first approved imipramine under the brand name Presamine in 1959.
Presamine was later discontinued.
Imipramine Warnings Like all antidepressants, imipramine carries a black-box warning because some people may become severely depressed and suicidal while taking the drug.
Talk to your doctors about the risks of suicide ideation before taking imipramine or any other antidepressant.
You shouldn’t take imipramine if: You’re allergic to imipramine or any of the drug’s inactive ingredients You just had a heart attack Ask your doctor about imipramine if you: Have glaucoma or other issues with increased pressure in the eye Have seizures Suffer from hormonal disorders like diabetes or thyroid disease Have Parkinson’s disease Have mood disorders, like schizophrenia or bipolar disorder Live in an extremely warm climate Have heart conditions, including congestive heart failure (CHF) or a slow or irregular heartbeat Just had a heart attack You’re younger than 25 or older than 65 Also, don’t expect to notice a big difference in your mood when you first start taking imipramine.
Regardless of the dose prescribed, imipramine — like most antidepressants — can take up to three or four weeks before you either notice a change or see the maximum effect of the dose you’re taking.
BasicDescription Back to Top Imipramine Side Effects Common Side Effects of Imipramine You should tell your doctor if any of the following side effects are severe or don’t go away: Difficulty sleeping Weakness Confusion Dry mouth Increased appetite Nausea, vomiting Constipation Racing or fast heartbeat Rash or itching Blurry vision Sweatiness Serious Side Effects of Imipramine You should stop using this medicine and call your doctor if you experience any of the following serious side effects: Dizziness upon standing, fainting Stroke, heart attack, or changes in heart rhythm Seizures Parkinson’s-like signs, such as hand tremors, pill-rolling of the hands, or dragging of the feet Blood abnormalities, like low white blood cell count and low levels of platelets, white blood cells, and red blood cells Suicidal thoughts Syndrome of inappropriate antidiuretic hormone (SIADH) Back to Top Imipramine Interactions You should tell your doctor about all prescription, non-prescription, illegal, recreational, herbal, nutritional, or dietary drugs you’re taking.
Don’t take imipramine if you are taking the following drugs: KlorCon (potassium phosphate) Drugs for bowel preparation, like potassium phosphate or potassium citrate Flumazenil Drugs for irregular heartbeat like dronedarone, Norpace or Norpace CR (disopyramide), and procainamide Parnate (tranylcypromine) Zyvox (linezolid) Emsam (selegiline transdermal) Like most TCAs, imipramine interacts with many drugs, so please discuss any concerns with your doctor or pharmacist before taking it.
Other drugs that interact with imipramine include: Cordarone, Nexterone, or Pacerone (amiodarone) Drugs for irregular heartbeat, like Tikosyn (dofetilide), dobutamine, and Betapace or Betapace AF ( sotalol ) Tagamet (cimetidine) Ephedra and ephedrine Epi-Pen, Epi-Pen, Jr.
( epinephrine ) Methadose and Dolophine (methadone) Biaxin (clarithromycin) Imipramine and Alcohol Impramine and alcohol can both cause dry mouth, dry eyes, dizziness, and confusion.
Drinking alcohol while taking imipramine may worsen these side effects, so you might want to avoid, or at least limit, alcohol while taking imipramine.
Imipramine and Grapefruit Juice Try to avoid eating grapefruit and drinking grapefruit juice while taking imipramine.
Grapefruit juice slows down how quickly the body is able to break down the imipramine, which could cause imipramine levels in the blood to rise dangerously high.
Back to Top Imipramine Dosage Generic imipramine is available in tablet form in the same doses as those found in Tofranil and Tofranil PM.
The brand name Tofranil comes in 10 milligram (mg), 25 mg, and 50 mg tablets, while the injection comes in vials containing 12.5 mg of Tofranil per milliliter of liquid (12.5 mg/ml).
Generic imipramine for injection is no longer available.
Tofranil-PM tablets come in strengths of 75 mg, 100 mg, 125 mg, and 150 mg.
The dose of imipramine varies based on the condition your doctor is treating.
For depression, your doctor may start you at a dose ranging anywhere from 25 mg to 75 mg a day for 3 to 4 days, and slowly increase the dose based on how you respond to treatment.
Unless your doctor has told you otherwise, you shouldn’t take more than 300 mg of imipramine a day.
People 65 and older generally shouldn’t take more than 100 mg of imipramine a day.
Higher doses of imipramine may cause confusion, bladder problems, loss of balance, and possibly increase the risk of falling in people ages 65 and over.
If your doctor prescribes imipramine for pain management, your doctor will determine how much you should take based on your weight and other factors.
Still, you shouldn’t take more than 300 mg of imipramine day.
Imipramine Overdose If you think you or someone else might have overdosed on imipramine, contact an emergency room at 911 or a poison control center 800-222-1222 right away.
Missed Dose of Imipramine If you miss a dose of Imipramine, try to take it as soon as you remember.
However, if it’s almost time for your next dose, skip the missed dose and continue on your regular dosing schedule.
Don’t take extra doses to make up for a missed one.
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